Expandable intervertebral implant for treatment of scoliosis

ABSTRACT

An expandable intervertebral implant, including a support component, an inferior component, including a first proximate end connected to the support component, a first distal end, a first top surface, and a first bottom surface, a superior component, including a second proximate end connected to the support component, a second distal end, a second top surface, and a second bottom surface, and a balloon connected to the first top surface and the second bottom surface and operatively arranged to expand the expandable intervertebral implant.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is filed under 35 U.S.C. § 120 as acontinuation-in-part of U.S. patent application Ser. No. 15/787,163,filed on Oct. 18, 2017, which application is hereby incorporated byreference in its entirety.

FIELD

The present disclosure relates to orthopedic surgery, and moreparticularly to an expandable intervertebral implant serving to improvealignment between vertebral elements of the spine affected by anabnormal curvature due to disc degeneration or scoliosis.

BACKGROUND

The spinal column, or backbone, is one of the most important parts ofthe body. It provides the main support, allowing us to stand upright,bend, and twist. As shown in FIG. 1, thirty three (33) individual bonesinterlock with each other to form the spinal column. The vertebrae arenumbered and divided into regions. The cervical vertebrae C1-C7 form theneck, support the head and neck, and allow nodding and shaking of thehead. The thoracic vertebrae T1-T12 join with the ribs to form the ribcage. The five lumbar vertebrae L1-L5 carry most of the weight of theupper body and provide a stable center of gravity when a person moves.Five vertebrae of the sacrum S and four of the coccyx C are fused. Thiscomprises the back wall of the pelvis. Intervertebral discs are locatedbetween each of the mobile vertebra. Intervertebral discs comprise athick outer layer with a crisscrossing fibrous structure annulus A thatsurrounds a soft gel-like center, the nucleus N. Discs function likeshock-absorbing springs. The annulus pulls the vertebral bodies togetheragainst the elastic resistance of the gel-filled nucleus. When we bend,the nucleus acts like a ball bearing, allowing the vertebral bodies toroll over the incompressible gel. Each disc works in concert with twofacet joints, forming a spinal motion segment. The biomechanicalfunction of each pair of facet joints is to guide and limit the movementof the spinal motion segment. The surfaces of the joint are coated withcartilage that helps each joint move smoothly. Directly behind thediscs, the ring-like vertebral bodies create a vertical tunnel calledthe spinal canal or neuro canal. The spinal cord and spinal nerves passthrough the spinal canal, which protects them from injury. The spinalcord is the major column of nerve tissue that is connected to the brainand serves as an information super-highway between the brain and thebody. The nerves in the spinal cord branch off to form pairs of nerveroots that travel through the small openings between the vertebrae andthe intervertebral foramens.

Various medical conditions require a surgeon to repair, remove and/orreplace the aforementioned discs. For example, in one surgicalprocedure, known as a discectomy (or diskectomy) with interbody fusion,the surgeon removes the nucleus of the disc and replaces it with animplant. As shown in FIG. 2, it may be necessary, for example, for thesurgeon to remove the nucleus of the disc between the L3 and L4vertebrae. Disc D_(L3-L4) is shown in an enlarged view in FIG. 3. Thisfigure also shows various anatomical structures of the spine, includingfacets F3A and F4A, facet joint FJ, spinous processes SP3 (not shown)and SP4, transverse processes TP3A and TP4A, and intervertebral foramenIF. FIG. 4 is a top view of the section of the spinal column shown inFIG. 3, with the L3 vertebra removed to expose annulus A and nucleus Nof disc D_(L3-L4). Neural canal NC is also shown. FIG. 5 is an anteriorperspective view of the section of the spinal column shown in FIG. 4.FIG. 6 is a partial cross-sectional view of the section of the spinalcolumn shown in FIG. 5, taken generally along line 6-6, but withvertebra L3 in place atop disc D_(L3-L4).

One common tool used in these spinal surgical procedures is anendoscope. A representative endoscope 30 is shown in FIG. 7A. Endoscopesare complex biomedical devices. The complexity results from the need forfiberoptic bundles and multiple long narrow channels to be containedwithin a tubular structure that is constrained by the limited dimensionsof the body cavity opening. As shown in FIG. 7A, endoscope 30 broadlycomprises light guide connector 31, light guide tube 32, control body33, and insertion tube 34. As will be described infra, the inflatableabrading device of the embodiment is introduced into the disc space viainsertion tube 34. As shown in FIG. 7B, surgeon 40 uses the endoscopeboth to observe and guide the procedure via monitor 41, and to introduceand manipulate surgical instruments and tools during surgery on patient45.

The endoscope is only one element of the system. Other required elementsare a light source, video processor, monitor and water bottle. For thepurpose of describing an endoscope in this disclosure, we refer tovideoscopes, which represent a newer technology in endoscope developmentas compared to fiberoptic endoscopes. In videoscopes, the “viewing”fibre bundle is replaced by a miniature charged coupled device (CCD)video camera chip that transmits signals via wires.

Videoscopes include three major sections: connector 31 (sometimesreferred to as the “umbilical” section), control body 33 and insertiontube 34. Endoscopes require a watertight internal compartment integratedthrough all components for electrical wiring and controls, whichprotects them from exposure to patient secretions during use andfacilitates the endoscope being submerged for cleaning and subsequentdisinfection. Example embodiments are not intended to be limited to anyparticular type of endoscope.

Control body 33 provides connections for four systems: the electricalsystem, the light system, the air and water system, and the suctionsystem. A cable with video signal, light control, and remote switchingfrom the video processor is connected in the electrical system. Awatertight cap is required for leak testing and reprocessing. Theelectrical connector is the only opening to the internal components. Theconnector is inserted into the light source and directs light via thefiberoptic bundle in the light guide to the distal end of the insertiontube. Air pressure is provided from a pump to the air pipe, and thewater bottle is also connected here (there is no water channel or waterconnection for bronchoscopes). In some endoscope models, the separateair and water channels merge just prior to the distal end where theyexit through a single channel. In other models, the air and waterchannels are totally separate and do not merge. The air and waterchannels are usually of one millimeter internal diameter, which is toosmall for brushing. A portable or wall suction system is connected tothe suction port. The Universal cord encases the electrical wiring andair, water and suction channels from the connector to the controlsection. Teflon® (PTFE) tubing is commonly used for channels, andadvances in technology have led to more pliable and smooth materials forinstrument channels with better anti-adhesion properties. The suctionchannel size can vary from two to four millimeters internal diameterdepending on scope make and model. There is a biopsy port on the side ofthe insertion tube that allows instruments to be passed down theinsertion tube to the distal end (referred to as the instrument channelor biopsy/suction channel).

Control body 33 has moveable knobs that allow the physician to controlall scope functions. The angulation control knobs drive the angulationwires and control the bending section at the distal end of the insertiontube, thereby providing two-dimensional angulation. Locking mechanismsare provided to hold the bending section in a specific position. Thesuction cylinder and valve connects the suction channel to theinstrument channel in the insertion tube. By pressing the valve button,suction can be provided to the instrument channel. The air/watercylinder and valve are similar to the suction cylinder/valve except thata two-way button valve is used in a dual channel cylinder therebyproviding air or water to the lens at the distal end to wash andinsufflate for better vision. Both valves are removable for cleaning.The air and water channels also require a cleaning adapter valve that isto be used at the end of each procedure. Insertion of the cleaningadapter initiates air flow through both air and water channels, and onceactivated, water is pumped through both channels. The instrument channelport (often referred to as the “biopsy port”) is located on the lowerpart of the control section. It enters the instrument channel at aY-piece union with the suction channel. A valve is required to close theport so that suctioning may be facilitated. Remote switches present onthe top of the control section are usually programmable, allowingcontrol of the video processor (i.e., contrast, iris and image capturefunctions).

Of all animals possessing a backbone, human beings are the onlycreatures who remain upright for significant periods of time. From anevolutionary standpoint, this erect posture has conferred a number ofstrategic benefits, not the least of which is freeing the upper limbsfor purposes other than locomotion. From an anthropologic standpoint, itis also evident that this unique evolutionary adaptation is a relativelyrecent change, and as such has not benefitted from natural selection asmuch as have backbones held in a horizontal attitude. As a result, thestresses acting upon the human backbone (or “vertebral column”), areunique in many senses, and result in a variety of problems or diseasestates that are peculiar to the human species.

The human vertebral column is essentially a tower of bones held uprightby fibrous bands called ligaments and contractile elements calledmuscles. There are seven bones in the neck or cervical region, twelve inthe chest or thoracic region, five in the lower back or lumbar region,and five in the pelvic or sacral region, which are normally fusedtogether to form the back part of the pelvis. This column of bones iscritical for providing structural support for the entire body.

Between the vertebral bones exist soft tissue structures, i.e., discs,composed of fibrous tissue and cartilage that are compressible and actas shock absorbers for sudden downward forces on the upright column. Thediscs allow the bones to move independently of each other, as well. Therepetitive forces which act on these intervertebral discs duringrepetitive activities of bending, lifting, and twisting cause them tobreak down or degenerate over time.

Presumably, because of humans' upright posture their intervertebraldiscs have a high propensity to degenerate. Overt trauma or coverttrauma, occurring in the course of repetitive activities,disproportionately affects the more highly mobile areas of the spine.Disruption of a disc's internal architecture leads to bulging,herniation, or protrusion of pieces of the disc and eventual disc spacecollapse. Resulting mechanical and even chemical irritation ofsurrounding neural elements (spinal cord and nerves) cause pain,attended by varying degrees of disability. In addition, loss of discspace height relaxes tension on the longitudinal spinal ligaments,thereby contributing to varying degrees of spinal instability such asspinal curvature. Asymmetric loss of disc space height with degenerationcauses adult degenerative scoliosis.

The time-honored method of addressing the issues of neural irritationand instability resulting from severe disc damage has largely focused onremoval of the damaged disc and fusing the adjacent vertebral elementstogether. Removal of the disc relieves the mechanical and chemicalirritation of neural elements, while osseous union (i.e., bone knitting)solves the problem of instability.

While cancellous bone appears ideal to provide the biologic componentsnecessary for osseous union to occur, it does not initially have thestrength to resist the tremendous forces that may occur in theintervertebral disc space, nor does it have the capacity to adequatelystabilize the spine until long term bony union occurs. For thesereasons, many spinal surgeons have found that interbody fusion usingbone alone has an unacceptably high rate of bone graft migration or evenexpulsion or nonunion due to structural failure of the bone or residualdegrees of motion that retard or prohibit bony union. Intervertebralprosthesis in various forms has therefore been used to provide immediatestability and to protect and preserve an environment that fosters growthof the grafted bone such that a structurally significant bony fusion canoccur.

U.S. Pat. No. 6,159,244 (Suddaby) exhibits an expandable cage capable ofnonparallel expansion but require a complex mechanism of ratchetingpillars. The implant disclosed in U.S. Pat. No. 5,483,463 (Qin et al.)is hollow and tubular, with communicating windows in the top and bottomsurfaces, which would permit fusion but the design does little tocorrect scoliosis.

Many interbody devices in present day use, whether expandable or not,are used largely to facilitate interbody fusion in cases of degenerativedisc disease and are not specifically designed to correct scoliosis,which is a pathologic curvature of the spine in the coronal or lateralplane that can be of degenerative, congenital, or idiopathic causes.

SUMMARY

According to aspects illustrated herein, there is provided an expandableintervertebral implant, comprising a support component, an inferiorcomponent, including a first proximate end connected to the supportcomponent, a first distal end, a first top surface, and a first bottomsurface, a superior component, including a second proximate endconnected to the support component, a second distal end, a second topsurface, and a second bottom surface, and a balloon connected to thefirst top surface and the second bottom surface and operatively arrangedto expand the expandable intervertebral implant.

According to aspects illustrated herein, there is provided an expandableintervertebral fusion implant, comprising a support component, at leastone inferior component, including a first proximate end connected to thesupport component, a first distal end, a first top surface, a firstbottom surface, and a first aperture, at least one superior component,including a second proximate end connected to the support component, asecond distal end, a second top surface, a second bottom surface, and asecond aperture, and an expansion mechanism arranged between the firsttop surface and the second bottom surface and operatively arranged to beexpanded to displace the at least one superior component relative to theat least one inferior component.

According to aspects illustrated herein, there is provided an expandableintervertebral implant, comprising a support component, an inferiorcomponent, including a first proximate end connected to the supportcomponent, a first distal end, a first top surface, and a first bottomsurface, a superior component, including a second proximate endconnected to the support component, a second distal end, a second topsurface, and a second bottom surface, and a wedging componentoperatively arranged to be slid along the first top surface and thesecond bottom surface and expand the expandable intervertebral implant.

According to aspects illustrated herein, there is provided an expandableintervertebral implant, comprising a support component, at least oneinferior component, including a first proximate end connected to thesupport component, a first distal end, a first top surface, and a firstbottom surface, at least one superior component, including, a secondproximate end connected to the support component, a second distal end, asecond top surface; and a second bottom surface, and a wedging componentoperatively arranged to be slid along the first top surface and thesecond bottom surface and expand the expandable intervertebral implant.

It is the object of this disclosure to provide for an expandableintervertebral implant having two vertebral endplate contact surfacesconnected in a pivotal fashion which can be separated from each otherwhen a third component is wedged between them along their longitudinalaxis.

This disclosure relates to an expandable intervertebral fusion implantserving to improve alignment between vertebral elements of the spineaffected by an abnormal curvature due to disc degeneration or scoliosis,thereby facilitating the development of a bony union between them andthus fostering proper spinal alignment and thus long term spinalstability.

It is an object of this disclosure to provide for an expandableintervertebral fusion implant that is both simple to manufacture andsimple to use in daily clinical surgical practice.

It is also an object of this disclosure that this device servespecifically to correct local spinal alignment issues between adjacentvertebral endplates such that scoliosis or abnormal curvature of thespine can be addressed through a minimally invasive approach.

According to aspects illustrated herein, there is provided a pair ofendplate support elements, which are generally rectangular, joinedtogether pivotally at one end. The pivotal end of the implant hasvertical separation struts that are of variable length with interspaceroughly representing the height of the normal disc space at the level tobe addressed.

The distal or non-pivotal end of the implant has two rectangularelements juxtaposed in close proximity, i.e., not separated by avertical member or strut, such that they form a wedge shape akin to thatof a dull knife blade or an adze.

The implant further comprises a third element in the form of a wedgingmember. The wedging member is inserted into the pivotal end of theimplant, which can be advanced along the axis of the longitudinal axisof the rectangular members, once they are positioned across a disc spacethat has undergone discectomy.

The wedging member is preferably substantially cylindrical in shape,with a diameter that approximates the vertical struts at the pivotalend. The cylindrical wedge component is placed between the rectangularelements at the pivotal end once the construct has been placed across adisc space and then is impelled toward the non-pivotal end, such thatsaid distal elements are separated from each other as the wedgingelement is advanced.

When the wedging cylinder has reached the distal or non-pivotal end ofthe implant, the rectangular elements become more or less parallel toeach other by virtue of the diameter of the cylinder approximating theheight of the pivotal end.

Each rectangular element will harbor apertures or perforation such thatbony or biologic materials placed within the implant, once expanded bythe cylinder, will have close apposition to adjacent vertebral endplatesand hence can foster interbody fusion.

Once the wedging cylinder has reached the distal end of the implant, itwill be locked into position by a stop which prevents it from simplyrolling back to its start point. By securing the wedging cylinder insuch a fashion, implant stability is preserved.

It should be noted that, in an example embodiment, the pivotal end ofthe implant will be anchored to the vertebrae with one or more bonescrews to prevent expulsion of the implant as the wedge cylinder isadvanced and as the implant changes from a triangular or trapezoidalshape to a more rectangular configuration.

The present disclosure provides not only for an expandable interbodyfusion implant, but also for an implant that can be placed via a lateralminimally invasive approach, from the easier access or convex side of ascoliotic spine, and restore the normal parallel attitude of adjacentendplates prior to insertion of final biologic fusion products.

Additionally, because the initial configuration of the implant is wedgeshaped, it can be used to breach and release the contralateral annulusand associated ligamentous structures, should this be desired.

By using the implant at each spinal segment containing non-paralleladjacent endplates, spinal alignment can be restored through a minimallyinvasive or lateral lumbar interbody fusion (XLIF) surgical approach.

These and other objects, features, and advantages of the presentdisclosure will become readily apparent upon a review of the followingdetailed description of the disclosure, in view of the drawings andappended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments are disclosed, by way of example only, withreference to the accompanying schematic drawings in which correspondingreference symbols indicate corresponding parts, in which:

FIG. 1 is an anterior perspective view of a spinal column;

FIG. 2 is an anterior perspective view of the lumbar section of thespinal column shown in FIG. 1;

FIG. 3 is a lateral perspective view of two vertebrae, a disc, andrelated spinal anatomy;

FIG. 4 is a top view of a section of the spinal column, taken generallyalong line 4-4 in FIG. 3;

FIG. 5 is an enlarged anterior perspective view of the spinal columnshown in FIG. 2, except with the top vertebra and all other structureabove the top vertebra removed;

FIG. 6 is a partial cross-sectional view of the top and bottom vertebraeand disc, taken generally along line 6-6 in FIG. 5;

FIG. 7A is a view of a typical endoscope;

FIG. 7B illustrates use of the endoscope shown in FIG. 7A by a surgeonperforming a discectomy (diskectomy);

FIG. 8 is a top perspective view of an expandable intervertebralimplant, in a collapsed state;

FIG. 9A is a side elevational view of the expandable intervertebralimplant shown in FIG. 8;

FIG. 9B is a side elevational view of the expandable intervertebralimplant shown in FIG. 8 in an expanded state;

FIG. 10 is an anterior perspective view of a spinal column including theexpandable intervertebral implant shown in FIG. 8;

FIG. 11A is a side elevational view of the expandable intervertebralimplant shown in FIG. 10 in a collapsed state;

FIG. 11B is a side elevational view of the expandable intervertebralimplant shown in FIG. 10 in an expanded state;

FIG. 12A is a side elevational view of the expandable intervertebralimplant taken generally of detail 12 in FIG. 8;

FIG. 12B is a side elevational view of an expandable intervertebralimplant;

FIG. 13A is a cross-sectional view of a vertical member taken generallyalong line 13A-13A in FIG. 8;

FIG. 13B is a cross-sectional view of a vertical member taken generallyalong line 13B-13B in FIG. 8;

FIG. 14 is a top perspective view of an expandable intervertebralimplant in a collapsed state;

FIG. 15A is a side elevational view of a plurality of expandableintervertebral implants secured in a spinal column in a collapsed state;

FIG. 15B is a side elevational view of the plurality of expandableintervertebral implants secured in a spinal column, as shown in FIG.15A, in an expanded state;

FIG. 16A is a top perspective view of an expandable intervertebralimplant, in a collapsed state;

FIG. 16B is a top perspective view of the expandable intervertebralimplant shown in FIG. 16A, in an expanded state;

FIG. 17A is a side elevational view of the expandable intervertebralimplant shown in FIG. 16A; and,

FIG. 17B is a side elevational view of the expandable intervertebralimplant shown in FIG. 16B.

DETAILED DESCRIPTION

At the outset, it should be appreciated that like drawing numbers ondifferent drawing views identify identical, or functionally similar,structural elements. It is to be understood that the claims are notlimited to the disclosed aspects.

Furthermore, it is understood that this disclosure is not limited to theparticular methodology, materials and modifications described and assuch may, of course, vary. It is also understood that the terminologyused herein is for the purpose of describing particular aspects only,and is not intended to limit the scope of the claims.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood to one of ordinary skill inthe art to which this disclosure pertains. It should be understood thatany methods, devices or materials similar or equivalent to thosedescribed herein can be used in the practice or testing of the exampleembodiments.

It should be appreciated that the term “substantially” is synonymouswith terms such as “nearly,” “very nearly,” “about,” “approximately,”“around,” “bordering on,” “close to,” “essentially,” “in theneighborhood of,” “in the vicinity of,” etc., and such terms may be usedinterchangeably as appearing in the specification and claims. It shouldbe appreciated that the term “proximate” is synonymous with terms suchas “nearby,” “close,” “adjacent,” “neighboring,” “immediate,”“adjoining,” etc., and such terms may be used interchangeably asappearing in the specification and claims. The term “approximately” isintended to mean values within ten percent of the specified value.

Adverting now to the figures, and as described previously, FIGS. 1-6depict various parts and sections of spinal anatomy, and FIGS. 7A and 7Bdepict a typical endoscope for use by a surgeon on a patient.

FIG. 8 is a top perspective view of expandable intervertebral implant110, in a collapsed state. FIG. 9A is a side elevational view ofexpandable intervertebral implant 110 in a collapsed state. FIG. 9B is aside elevational view of expandable intervertebral implant 110 in anexpanded state. Expandable intervertebral implant 110 generallycomprises inferior component 120, superior component 140, supportcomponent 160, and wedging component 190.

Inferior component 120 comprises end 122, end 124, top surface 126, andbottom surface 128. Inferior component 120 is connected to supportcomponent 160 at end 122. In an example embodiment, inferior component120 is secured to cross member 162 such that it is perpendicular tovertical members 174 and 176. In an example embodiment, inferiorcomponent 120 is secured to support component 160 at a non-perpendicularangle to vertical members 174 and 176. Inferior component 120 mayfurther comprise aperture 134, which extends from top surface 126 tobottom surface 128. Aperture 134 allows bony or biologic materialsplaced within expandable intervertebral implant 110, once expanded, tohave close apposition to adjacent vertebral endplates and thereby fosterinterbody fusion. Top surface 126 further comprises lip 130 and stop132. Lip 130 extends upward from top surface 126 and is arrangedgenerally proximate end 124. Lip 130 is arranged as a boundary forwedging component 190 (i.e., to keep wedging component 190 withinexpandable intervertebral implant 110). Stop 132 extends upward from topsurface 126 and is arranged axially inward (i.e., in axial directionAD2) from end 124 as shown in the figures. Stop 132 is designed to allowwedging component 190 to move in axial direction AD1, but once beyondstop 132, to prevent movement of wedging component 190 in axialdirection AD2 and maintain its position as shown in FIG. 9B.

Superior component 140 comprises end 142, end 144, top surface 148, andbottom surface 146. Superior component 140 is connected to supportcomponent 160 generally at end 142. Specifically, superior component 140is connected to hinges 180 and 182, and hinges 180 and 182 are connectedto support component 160. In an example embodiment, hinges 180 and 182are connected to cross-member 168. In an example embodiment, expandableintervertebral implant 110 comprises one or more hinges. Superiorcomponent 140 may further comprise aperture 154, which extends from topsurface 148 to bottom surface 146. Aperture 154 allows bony or biologicmaterials placed within expandable intervertebral implant 110, onceexpanded, to have close apposition to adjacent vertebral endplates andthereby foster interbody fusion. Bottom surface 146 further compriseslip 150 and stop 152. Lip 150 extends downward from bottom surface 146and is arranged generally proximate end 144. Lip 150 is arranged as aboundary for wedging component 190 (i.e., to keep wedging component 190within expandable intervertebral implant 110). Stop 152 extends downwardfrom bottom surface 146 and is arranged axially inward (i.e., in axialdirection AD2) from end 144 as shown in the figures. Stop 152 isdesigned to allow wedging component 190 to move in axial direction AD1,but once beyond stop 152, to prevent movement of wedging component 190in axial direction AD2 and maintain its position as shown in FIG. 9B.

It should be appreciated that the orientation of hinges 180 and 182 canbe reversed such that inferior component 120 is hingedly connected tosupport component 160. In this embodiment, superior component 140 isconnected to support component 160. Specifically, end 142 is secured tocross-member 168 such that superior component 140 is generallyperpendicular to vertical members 174 and 176. In an example embodiment,superior component 140 can be secured to support component 160 at anon-perpendicular angle (i.e., non-perpendicular to vertical members 174and 176). Hinges 180 and 182 are secured to cross-member 162 and end 122of inferior component 120 is secured to hinges 180 and 182. In anexample embodiment, both inferior component 120 and superior component140 are hingedly connected to support component 160.

Support component 160 generally comprises cross-member 162, cross-member168, vertical member 174, and vertical member 176. Cross-member 162further comprises flange 164 having through-bore 166 for anchoringexpandable intervertebral implant 110 to the vertebrae and preventexpulsion of expandable intervertebral implant 110 as wedging component190 is advanced therein. Flange 164 extends generally downward fromcross-member 162. Cross-member 168 further comprises flange 170 havingthrough-bore 172 for anchoring expandable intervertebral implant 110 tothe vertebrae and prevent expulsion of expandable intervertebral implant110 as wedging component 190 is advanced therein. Flange 168 extendsgenerally upward from cross-member 168. Vertical members 174 and 176connect cross-member 168 to cross-member 162. Vertical members 174 and176 are generally adjustable (i.e., can be lengthened or shortened) aswill be discussed in greater detail with respect to FIGS. 13A and 13B.

Wedging component 190 is generally cylindrical comprising radiallyoutward facing surface 192, end surface 194, and end surface 196.Wedging component 190 is designed to be inserted into expandableintervertebral implant 110 in axial direction AD1 with end surfaces 194and 196 generally perpendicular to ends 122 and 124. As wedgingcomponent 190 is advanced in expandable intervertebral implant 110,radially outward facing surface 192 slides along top surface 126 andbottom surface 146, thereby forcing superior component 140 upward andaway from superior component 120. Once wedging component 190 passesstops 132 and 152, wedging component 190 is prevented from movement inaxial direction AD2, unless superior component 140 is forced further inthe upward direction, thereby releasing stops 132 and 152 (wedgingcomponent 190 can then be removed from expandable intervertebral implant110). Lips 130 and 150 also provide an axial boundary preventing wedgingcomponent 190 from “falling out” of expandable intervertebral implant110 in axial direction AD1. Inferior component 120 and superiorcomponent 140 may further comprise lateral rails for end surfaces 194and 196 to slide against to help ensure that wedging component 190 doesnot yaw (i.e., twist or oscillate about a vertical axis) as it is beingadvanced within expandable intervertebral implant 110 (i.e., keep endsurfaces 194 and 196 perpendicular to ends 122 and 124). It should beappreciated that wedging component 190 can be any shape suitable toslide along top surface 126 and bottom surface 146 and expand expandableintervertebral implant 110, such as rectangular prism, elliptical prism,triangular prism, spherical, etc. It should also be appreciated that thesize of wedging component 190 should be relative to the vertical heightof support component 160. When wedging component 190 is fully insertedin expandable intervertebral implant 110, it is desired that superiorcomponent 140 is substantially parallel to inferior component 120.Therefore, the diameter of wedging component 190 should be slightly lessthan the vertical length of vertical members 174 and 176. Since verticalmembers 174 and 176 are adjustable, as will be discussed in greaterdetail below, a variety of sizes of wedging component 190 should beavailable such that the surgeon can choose the correct size duringoperation.

FIG. 10 is an anterior perspective view of a spinal column includingexpandable intervertebral implant 110. FIG. 11A is a side elevationalview of expandable intervertebral implant 110 shown in FIG. 10 in acollapsed state. FIG. 11B is a side elevational view of the expandableintervertebral implant 110 shown in FIG. 10 in an expanded state.Expandable intervertebral implant 110 is inserted into the spinal columnbetween, for example, the L3 and L4 vertebrae, or where disc D_(L3-L4)should be. Expandable intervertebral implant 110 is secured to thevertebrae, for example, by fasteners 104 and 106. In an exampleembodiment, fastener 104 secures expandable intervertebral implant 110to lumbar vertebra L3 and fastener 106 secures expandable intervertebralimplant 110 to lumbar vertebra L4. Fasteners 104 and 106 may be screws,anchors, bolts, etc., or any other suitable fastening mechanism,including adhesives. Expandable intervertebral implant 110 is thenvertically expanded until the desired height is reached. Supportcomponent 160 is expanded by lengthening vertical members 174 and 176 toa suitable length, and then a suitable size wedging component 190 ischosen and advanced in expandable intervertebral implant 110 until it isfully expanded. Expandable intervertebral implant 110 is then filledwith fusion material and left in situ. It should be appreciated thatvertical members 174 and 176 can be adjusted to a suitable length priorto inserting expandable intervertebral implant 110 into the spinalcolumn.

FIG. 12A is a side elevational view of expandable intervertebral implant110 taken generally of detail 12 in FIG. 8. FIG. 12B is a sideelevational view of an example embodiment of expandable intervertebralimplant 110 having hooks attached to the lips. As shown, inferiorcomponent 120 further comprises hook 131 connected to the end of lip130. Similarly, superior component 140 further comprises hook 151connected to the end of lip 150. Hook 131 is arranged facing axialdirection AD1 and hook 151 is arranged facing axial direction AD2, suchthat superior component 140 can only be separated from inferiorcomponent 120 a predetermined distance. Once that predetermined distanceis reached, hooks 131 and 151 engage and prevent superior component 140from separating further from inferior component 120. In an exampleembodiment, hook 131 is arranged facing axial direction AD2 and hook 151is arranged facing axial direction AD1. It should be appreciated thatany method suitable for preventing excessive vertical displacement ofsuperior component 140 relative to inferior component 120, such asstops, flanges, etc., or a leash component such as a string or cord of apredetermined length may be used.

FIG. 13A is a cross-sectional view of vertical member 174 takengenerally along line 13A-13A in FIG. 8. As shown, vertical member 174comprises inner bar 174A arranged to slidingly engage outer bar 174B(i.e., vertical member 174 is a telescoping bar). In the embodimentshown, inner bar 174A comprises a plurality of pins 100 andcorresponding spring members 102. Pins 100 protrude from holes 175A ininner bar 174A, specifically, pins 100 are forced radially outwardthrough holes 175A by spring members 102. Pins 100 are forced radiallyinward such that inner bar 174A can be slid axially within outer bar174B. One of pins 100 is aligned with hole 175B in outer bar 174B oncethe desired length of vertical member 174 is achieved. In an exampleembodiment, vertical member 174 is cylindrical, inner bar 174A comprisesradially outer threading, and outer bar 174B comprises radially innerthreading such that the length of vertical member 174 is adjustable byrotating one of inner bar 174A or outer bar 174B relative to the other.It should be appreciated that telescoping members are known in the artand that any suitable telescoping design may be used. This similarlocking mechanism (i.e., the push-pins) may be used on cross-members 162and 168. In an example embodiment, one or more cross-members have alocking mechanism. In an example embodiment, no cross-members have alocking mechanism.

FIG. 13B is a cross-sectional view of vertical member 176 takengenerally along line 13B-13B in FIG. 8. As shown, vertical member 176comprises inner bar 176A arranged to slidingly engage outer bar 176B(i.e., vertical member 176 is a telescoping bar). In the embodimentshown, inner bar 176A comprises a plurality of pins 100 andcorresponding spring members 102. Pins 100 protrude from holes 177A ininner bar 176A, specifically, pins 100 are forced radially outwardthrough holes 177A by spring members 102. Pins 100 are forced radiallyinward such that inner bar 176A can be slid axially within outer bar176B. One of pins 100 is aligned with hole 177B in outer bar 176B oncethe desired length of vertical member 176 is achieved. In an exampleembodiment, vertical member is cylindrical, inner bar 176A comprisesradially outer threading, and outer bar 176B comprises radially innerthreading such that the length of vertical member 176 is adjustable byrotating one of inner bar 176A or outer bar 176B relative to the other.It should be appreciated that telescoping members are known in the artand that any suitable telescoping design may be used.

FIG. 14 is a top perspective view of expandable intervertebral implant210 in a collapsed state. Expandable intervertebral implant 210generally comprises inferior components 220A and 220B, superiorcomponents 240A and 240B, support component 260, and wedging component290.

Inferior component 220A comprises end 222A, end 224A, top surface 226A,and bottom surface 228A. Inferior component 220A is connected to supportcomponent 260 at end 222A. In an example embodiment, inferior component220A is secured to cross member 262 such that it is perpendicular tovertical members 274 and 276. In an example embodiment, inferiorcomponent 220A is secured to support component 260 at anon-perpendicular angle to vertical members 274 and 276. Top surface226A further comprises lip 230A and stop 232A. Lip 230A extends upwardfrom top surface 226A and is arranged generally proximate end 224A. Lip230A is arranged as a boundary for wedging component 290 (i.e., to keepwedging component 290 within expandable intervertebral implant 210).Stop 232A extends upward from top surface 226A and is arranged axiallyinward (i.e., in axial direction AD2) from end 224A as shown in FIG. 14.Stop 232A is designed to allow wedging component 290 to move in axialdirection AD1, but once beyond stop 232A, to prevent movement of wedgingcomponent 290 in axial direction AD2 and maintain its position.

Inferior component 220B comprises end 222B end 224B, top surface 226B,and bottom surface 228B. Inferior component 220B is connected to supportcomponent 260 at end 222B. In an example embodiment, inferior component220B is secured to cross member 262 such that it is perpendicular tovertical members 274 and 276. In an example embodiment, inferiorcomponent 220B is secured to support component 260 at anon-perpendicular angle to vertical members 274 and 276. Top surface226B further comprises lip 230B and stop 232B. Lip 230B extends upwardfrom top surface 226B and is arranged generally proximate end 224B. Lip230B is arranged as a boundary for wedging component 290 (i.e., to keepwedging component 290 within expandable intervertebral implant 210).Stop 232B extends upward from top surface 226B and is arranged axiallyinward (i.e., in axial direction AD2) from end 224B as shown in FIG. 14.Stop 232B is designed to allow wedging component 290 to move in axialdirection AD1, but once beyond stop 232B, to prevent movement of wedgingcomponent 290 in axial direction AD2 and maintain its position.

Superior component 240A comprises end 242A, end 244A, top surface 248A,and bottom surface 246A. Superior component 240A is connected to supportcomponent 260 generally at end 242A. Specifically, superior component240A is connected to hinge 280, and hinge 280 is connected to supportcomponent 260. In an example embodiment, hinge 280 is connected tocross-member 268. In an example embodiment, expandable intervertebralimplant 210 comprises one or more hinges. Bottom surface 246A furthercomprises lip 250A and stop 252A. Lip 250A extends downward from bottomsurface 246A and is arranged generally proximate end 244A. Lip 250A isarranged as a boundary for wedging component 290 (i.e., to keep wedgingcomponent 290 within expandable intervertebral implant 210). Stop 252Aextends downward from bottom surface 246A and is arranged axially inward(i.e., in axial direction AD2) from end 244A as shown in FIG. 14. Stop252A is designed to allow wedging component 290 to move in axialdirection AD1, but once beyond stop 252A, to prevent movement of wedgingcomponent 290 in axial direction AD2 and maintain its position.

Superior component 240B comprises end 242B, end 244B, top surface 248B,and bottom surface 246B. Superior component 240B is connected to supportcomponent 260 generally at end 242B. Specifically, superior component240B is connected to hinge 282, and hinge 282 is connected to supportcomponent 260. In an example embodiment, hinge 282 is connected tocross-member 268. In an example embodiment, expandable intervertebralimplant 210 comprises one or more hinges. Bottom surface 246B furthercomprises lip 250B and stop 252B. Lip 250B extends downward from bottomsurface 246B and is arranged generally proximate end 244B. Lip 250B isarranged as a boundary for wedging component 290 (i.e., to keep wedgingcomponent 290 within expandable intervertebral implant 210). Stop 252Bextends downward from bottom surface 246B and is arranged axially inwardfrom end 244B (i.e., in axial direction AD2) as shown in FIG. 14. Stop252B is designed to allow wedging component 290 to move in axialdirection AD1, but once beyond stop 252B, to prevent movement of wedgingcomponent 290 in axial direction AD2 and maintain its position.

It should be appreciated that the orientation of hinges 280 and 282 canbe reversed such that inferior components 220A and 220B are hingedlyconnected to support component 260. In this embodiment, superiorcomponents 240A and 240B are connected to support component 260.Specifically, ends 242A and 242B are secured to cross-member 268 suchthat superior components 240A and 240B are generally perpendicular tovertical members 274 and 276. In an example embodiment, superiorcomponents 240A and 240B can each be secured to support component 260 ata non-perpendicular angle to vertical members 274 and 276. Hinges 280and 282 are secured to cross-member 262, and ends 222A and 222B aresecured to hinges 280 and 282, respectively. Additionally, it should beappreciated that in an example embodiment, inferior components 220A and220B and superior components 240A and 240B are hingedly connected tosupport component 260.

Support component 260 generally comprises cross-member 262, cross-member268, vertical member 274, and vertical member 276. Cross-member 262further comprises flange 264 having through-bore 266 for anchoringexpandable intervertebral implant 210 to the vertebrae and preventexpulsion of expandable intervertebral implant 210 as wedging component290 is advanced therein. Flange 264 extends generally downward fromcross-member 262. Cross-member 268 further comprises flange 270 havingthrough-bore 272 for anchoring expandable intervertebral implant 210 tothe vertebrae and prevent expulsion of expandable intervertebral implant210 as wedging component 290 is advanced therein. Flange 270 extendsgenerally upward from cross-member 268. Vertical members 274 and 276connect cross-member 268 to cross-member 262. Vertical members 274 and276 are generally adjustable (i.e., can be lengthened or shortened) aswas previously discussed with respect to vertical members 174 and 176.In an example embodiment, vertical members 274 and 276 are telescopingbars and have locking mechanism for setting them at a determined length.

Wedging component 290 is generally cylindrical comprising radiallyoutward facing surface 292, end surface 294, and end surface 296.Wedging component 290 is designed to be inserted into expandableintervertebral implant 210 in axial direction AD1 with end surfaces 294and 296 generally perpendicular to, for example, ends 222A and 224A. Aswedging component 290 is advanced in expandable intervertebral implant210, radially outward facing surface 292 slides along top surfaces226A-B and bottom surfaces 246A-B, thereby forcing superior components240A-B upward and away from inferior components 220A-B. Once wedgingcomponent 290 passes stops 232A-B and 252A-B, wedging component 290 isprevented from movement in axial direction AD2, unless superiorcomponents 240A-B are forced further in the upward direction, therebyreleasing stops 232A-B and 252A-B (wedging component 290 can then beremoved from expandable intervertebral implant 210). Lips 230A-B and250A-B also provide an axial boundary preventing wedging component 290from “falling out” of expandable intervertebral implant 210 in axialdirection AD1. Inferior components 220A-B and superior components 240A-Bmay further comprise lateral rails for end surfaces 294 and 196 to slideagainst to help ensure that wedging component 290 does not yaw (i.e.,twist or oscillate about a vertical axis) as it is being advanced withinexpandable intervertebral implant 210 (i.e., keep end surfaces 294 and296 perpendicular to ends 222A and 224B). It should be appreciated thatwedging component 290 can be any shape suitable to slide along topsurfaces 226A-B and bottom surfaces 246A-B and expand expandableintervertebral implant 210, such as rectangular prism, elliptical prism,triangular prism, spherical, etc. It should also be appreciated that thesize of wedging component 290 should be relative to the vertical heightof support component 260. When wedging component 290 is fully insertedin expandable intervertebral implant 210, it is desired that superiorcomponents 240A-B are substantially parallel to inferior components120A-B. Therefore, the diameter of wedging component 290 should beslightly less than the vertical length of vertical members 274 and 276.Since vertical members 274 and 276 are adjustable, as previouslydiscussed with respect to vertical members 174 and 176, a variety ofsizes of wedging component 290 should be available such that the surgeoncan choose the correct size during operation. Additionally, in anexample embodiment, support component 260 is laterally expandable.Specifically, cross-members 262 and 268 are adjustable similar to thatof vertical members 174 and 176 as previously discussed.

FIG. 15A is a side elevational view of a plurality of expandableintervertebral implants 110 secured in spinal column 10 in a collapsedstate. Expandable intervertebral implants 110 are inserted betweenlumbar vertebrae L1-L4 and secured thereto. FIG. 15B is a sideelevational view of the plurality of expandable intervertebral implants110, as shown in FIG. 15A, secured in spinal column 10 in an expandedstate. As each of expandable intervertebral implants 110 are expanded(i.e., wedging component 90 is advanced therein), lumbar vertebrae L1-L4align and spinal column 10 straightens.

FIG. 16A is a top perspective view of expandable intervertebral implant310, in a collapsed state. FIG. 16B is a top perspective view of theexpandable intervertebral implant 310, in an unexpanded state. FIG. 17Ais a side elevational view of expandable intervertebral implant 310, inthe collapsed state. FIG. 17B is a side elevational view of expandableintervertebral implant 310, in the expanded state.

Expandable intervertebral implant 310 generally comprises inferiorcomponent 320, superior component 340, support component 360, and anexpansion mechanism, or balloon 390. It should be appreciated that anyexpansion mechanism can be used in addition to or in place of theballoon. For example, expansion mechanism 390 may include a scissorjack, a bottle jack, a screw jack, a worm screw jack, etc. Additionally,expansion mechanism 390 may comprise a resilient material that can becompressed and held in a compressed state, and once released from itscompressed state, the resilient material expands and thus expandsexpandable intervertebral implant 310. In some embodiments, expansionmechanism 390 comprises Nickel titanium or Nitinol (part of shape memoryalloy), which is a metal alloy of nickel and titanium. In suchembodiments, the Nitinol or other shape memory material undergoesdeformation (e.g., at a first temperature) and then recovers itsoriginal, undeformed shape (e.g., at a second temperature). In otherembodiments, the shape memory material is able to recover its original,undeformed shape without the need for temperature change.

Inferior component 320 comprises end 322, end 324, top surface 326, andbottom surface 328. Inferior component 320 is connected to supportcomponent 360 at end 322. In an example embodiment, inferior component320 is secured to cross member 362 such that it is perpendicular tovertical members 374 and 376. In an example embodiment, inferiorcomponent 320 is secured to support component 360 at a non-perpendicularangle to vertical members 374 and 376. Inferior component 320 mayfurther comprise aperture 334, which extends from top surface 326 tobottom surface 328. Aperture 334 allows bony or biologic materialsplaced within expandable intervertebral implant 310, once expanded, tohave close apposition to adjacent vertebral endplates and thereby fosterinterbody fusion.

Superior component 340 comprises end 342, end 344, top surface 348, andbottom surface 346. Superior component 340 is connected to supportcomponent 360 generally at end 342. Specifically, superior component 340is connected to hinges 380 and 382, and hinges 380 and 382 are connectedto support component 360. In an example embodiment, hinges 380 and 382are connected to cross-member 368. In an example embodiment, expandableintervertebral implant 310 comprises one or more hinges. Superiorcomponent 340 may further comprise aperture 354, which extends from topsurface 348 to bottom surface 346. Aperture 354 allows bony or biologicmaterials placed within expandable intervertebral implant 310, onceexpanded, to have close apposition to adjacent vertebral endplates andthereby foster interbody fusion.

It should be appreciated that the orientation of hinges 380 and 382 canbe reversed such that inferior component 320 is hingedly connected tosupport component 360. In this embodiment, superior component 340 isconnected to support component 360. Specifically, end 342 is secured tocross-member 368 such that superior component 340 is generallyperpendicular to vertical members 374 and 376. In some embodiments,superior component 340 can be secured to support component 360 at anon-perpendicular angle (i.e., non-perpendicular to vertical members 374and 376). Hinges 380 and 382 are secured to cross-member 362 and end 322of inferior component 320 is secured to hinges 380 and 382. In anexample embodiment, both inferior component 320 and superior component340 are hingedly connected to support component 360.

Support component 360 generally comprises cross-member 362, cross-member368, vertical member 374, and vertical member 376. It should beappreciated that support component 360 is substantially similar tosupport component 160 shown in FIGS. 8 and 9A-B. Cross-member 362further comprises flange 364 having through-bore 366 for anchoringexpandable intervertebral implant 310 to a vertebra and preventexpulsion of expandable intervertebral implant 310 as balloon 390 isexpanded or inflated therein. Flange 364 extends generally downward fromcross-member 362. Cross-member 368 further comprises flange 370 havingthrough-bore 372 for anchoring expandable intervertebral implant 310 toa vertebra and prevent expulsion of expandable intervertebral implant310 as balloon 190 is expanded or inflated therein. Flange 368 extendsgenerally upward from cross-member 368. Vertical members 374 and 376connect cross-member 368 to cross-member 362. Vertical members 374 and376 are generally adjustable (i.e., can be lengthened or shortened) aswas previously discussed with respect to FIGS. 13A and 13B.

Balloon 390 is generally an elastomeric balloon comprising one or moreports, for example, ports 392A and 392B. Balloon 390 is designed to beexpanded or inflated in expandable intervertebral implant 310 generallyin longitudinal direction LD1 or longitudinal direction LD1. Balloon 390is connected to top surface 326 of inferior component 320 and bottomsurface 346 of superior component 340 proximate to or at ends 324 and344. In some embodiments, balloon 390 is connected to inferior componentat a position between ends 322 and 324 and connected to superiorcomponent at a position between ends 342 and 344. As balloon 390 isinflated or expanded in expandable intervertebral implant 310, superiorcomponent 340 is forced upward (e.g., in longitudinal direction LD1) andaway from superior component 320. Balloon 390 comprises ports 392A and392B through which fluid is introduced to inflate or expand balloon 390.Expandable intervertebral implant 390 may further comprise one or moretubes, for example, tubes 394A and 394B, connected to the one or moreports. Tubes 394A and 394B are connected to ports 392A and 392B,respectively. Tubes 394A and 394B comprise openings 396A and 396B. Fluidcan be injected in direction AD1 through openings 396A-B, tubes 394A-B,and ports 392A-B. The fluid may be, for example, hardenable such thatonce expandable intervertebral implant 310 is expanded to a suitableheight, the fluid can be allowed to harden and permanently set suchheight. It should be appreciated that although tubes 394A-B are shownpositioned along top surface 326, they can be provided at any suitableposition. For example, in some embodiments, tubes 394A-B are positionedat least partially within inferior component 320 between top surface 326and bottom surface 328. In some embodiments, tubes 394A-B are positionedat least partially within superior component 320 between top surface 326and bottom surface 328. In some embodiments, tubes 394A-B are positionedalong bottom surface 346. It should be appreciated that balloon 390 canbe any shape suitable to connect to or abut against top surface 326 andbottom surface 346 and expand expandable intervertebral implant 310,such as cylindrical, rectangular prism, elliptical prism, triangularprism, spherical, etc. When balloon 390 is fully inflated or expanded inexpandable intervertebral implant 310, it is desired that superiorcomponent 340 is substantially parallel to inferior component 320. Insome embodiments, balloon 390 further comprises one or more limit cordsor filaments, for example, limit cords or filaments 398A and 398B. Limitcords 398A-B are operatively arranged to limit the amount that balloon390 can be expanded or inflated and/or the distance that superiorcomponent 340 can be displaced relative to inferior component. Limitcords 398A-B are generally inelastic. Limit cords 398A-B may be arrangedwithin balloon 390, along the external surface of balloon 390, orseparate from balloon 390 between top surface 326 and bottom surface346. In some embodiments, balloon 390 is fixedly secured to superiorcomponent 340 and inferior component 320. In some embodiments, balloon390 is removably secured to superior component 340 and inferiorcomponent 320 such that, for example, balloon 390 can be removed tocollapse superior component 340 relative to inferior component 320.

Expandable intervertebral implant 310 can be implanted in a spinalcolumn similarly to expandable intervertebral implant 110 as shown inFIGS. 10 and 11A-B. Expandable intervertebral implant 310 is insertedinto the spinal column between, for example, the L3 and L4 vertebrae, orwhere disc D_(L3-L4) should be. Expandable intervertebral implant 310 issecured to the vertebrae using fasteners (e.g., screws, anchors, bolts,etc., or any other suitable fastening mechanism, including adhesives).Expandable intervertebral implant 310 is then vertically expanded untilthe desired height is reached. Support component 360 is expanded bylengthening vertical members 374 and 376 to a suitable length, and thenfluid is injected into port 392A and/or port 392B to inflate balloon 390in expandable intervertebral implant 310 until it is fully expanded.Expandable intervertebral implant 310 is then filled with fusionmaterial and left in situ. It should be appreciated that verticalmembers 374 and 376 can be adjusted to a suitable length prior toinserting expandable intervertebral implant 310 into the spinal column.

It will be appreciated that various aspects of the disclosure above andother features and functions, or alternatives thereof, may be desirablycombined into many other different systems or applications. Variouspresently unforeseen or unanticipated alternatives, modifications,variations, or improvements therein may be subsequently made by thoseskilled in the art which are also intended to be encompassed by thefollowing claims.

REFERENCE NUMERALS

-   10 Spinal column-   12 Ligament-   C1-C7 Cervical vertebrae-   T1-T12 Thoracic vertebrae-   L1-L5 Lumbar vertebrae-   S Sacrum-   C Coccyx-   D_(L1-L2) Disc-   D_(L2-L3) Disc-   D_(L3-L4) Disc-   D_(L4-L5) Disc-   F Facet-   FJ Facet joint-   SP Spinous process-   TP Transverse process-   IF Intervertebral foramen-   NC Neural canal-   A Annulus-   N Nucleus-   DH Disc space height-   30 Endoscope-   31 Light guide connector-   32 Light guide tube-   33 Control body-   34 Insertion tube-   40 Surgeon-   42 Monitor-   45 Patient-   100 Pins-   102 Spring members-   104 Fastener-   106 Fastener-   110 Expandable intervertebral (fusion) implant-   120 Inferior component-   122 End-   124 End-   126 Top surface-   128 Bottom surface-   130 Lip-   131 Hook-   132 Stop-   134 Aperture-   140 Superior component-   142 End-   144 End-   146 Bottom surface-   148 Top surface-   150 Lip-   151 Hook-   152 Stop-   154 Aperture-   160 Support component-   162 Cross-member-   164 Flange-   166 Through-bore-   168 Cross-member-   170 Flange-   172 Through-bore-   174 Vertical member-   174A Inner bar-   174B Outer bar-   175A Holes-   175B Hole-   176 Vertical member-   176A Inner bar-   176B Outer bar-   177A Holes-   177B Hole-   180 Hinge-   182 Hinge-   190 Wedging component-   192 Radially outward facing surface-   194 End surface-   196 End surface-   210 Expandable intervertebral (fusion) implant-   220A Inferior component-   220B Inferior component-   222A End-   222B End-   224A End-   224B End-   226A Top surface-   226A Top surface-   228A Bottom surface-   228A Bottom surface-   230A Lip-   230B Lip-   232A Stop-   232B Stop-   240A Superior component-   240B Superior component-   242A End-   242B End-   244A End-   244B End-   246A Bottom surface-   246A Bottom surface-   248A Top surface-   248A Top surface-   250A Lip-   250B Lip-   252A Stop-   252B Stop-   260 Support component-   262 Cross-member-   264 Flange-   266 Through-bore-   268 Cross-member-   270 Flange-   272 Through-bore-   274 Vertical member-   276 Vertical member-   280 Hinge-   282 Hinge-   290 Wedging component-   292 Radially outward facing surface-   294 End surface-   296 End surface-   310 Expandable intervertebral (fusion) implant-   320 Inferior component-   322 End-   324 End-   326 Top surface-   328 Bottom surface-   334 Aperture-   340 Superior component-   342 End-   344 End-   346 Bottom surface-   348 Top surface-   354 Aperture-   360 Support component-   362 Cross-member-   364 Flange-   366 Through-bore-   368 Cross-member-   370 Flange-   372 Through-bore-   374 Vertical member-   376 Vertical member-   380 Hinge-   382 Hinge-   390 Expansion mechanism or balloon-   392A Port-   392B Port-   394A Tube-   394B Tube-   396A Opening-   396B Opening-   398A Limit cord or filament-   398B Limit cord or filament (not shown)-   AD1 Axial direction-   AD2 Axial direction-   LD1 Longitudinal direction-   LD2 Longitudinal direction

What is claimed is:
 1. An expandable intervertebral implant, comprising:a support component; an inferior component, including: a first proximateend connected to the support component; a first distal end; a first topsurface; and, a first bottom surface; a superior component, including: asecond proximate end connected to the support component; a second distalend; a second top surface; and, a second bottom surface; and, a balloonconnected to the first top surface and the second bottom surface andoperatively arranged to expand the expandable intervertebral implant. 2.The expandable intervertebral implant as recited in claim 1, wherein thesuperior component is hingedly connected to the support component. 3.The expandable intervertebral implant as recited in claim 1, wherein theinferior component is hingedly connected to the support component. 4.The expandable intervertebral implant as recited in claim 2, wherein thesuperior component is connected to the support component via one or morehinges.
 5. The expandable intervertebral implant as recited in claim 2,wherein the support component comprises: a first cross-member; a secondcross-member; and, one or more vertical members connecting the first andsecond cross-members.
 6. The expandable intervertebral implant asrecited in claim 5, wherein the first cross-member comprises a firstflange having a first through-bore.
 7. The expandable intervertebralimplant as recited in claim 6, wherein the second cross-member comprisesa second flange having a second through-bore.
 8. The expandableintervertebral implant as recited in claim 5, wherein each of the one ormore vertical members is adjustable in length.
 9. The expandableintervertebral implant as recited in claim 8, wherein at least one ofthe one or more vertical members comprises a plurality of locking pinsoperatively arranged to lock the one or more vertical members at alength.
 10. The expandable intervertebral implant as recited in claim 2,wherein the inferior component further comprises a first aperture andthe superior component further comprises a second aperture.
 11. Theexpandable intervertebral implant as recited in claim 2, wherein theballoon comprises at least one port, wherein the at least one port isoperatively arranged to allow fluid to be injected into and inflate theballoon.
 12. The expandable intervertebral implant as recited in claim11, further comprising at least one tube connected to the at least oneport.
 13. The expandable intervertebral implant as recited in claim 2,wherein when the expandable intervertebral implant is in a fullyexpanded state, the superior component is substantially parallel to theinferior component.
 14. The expandable intervertebral implant as recitedin claim 1, further comprising at least one limit cord operativelyarranged to limit the expansion of the intervertebral implant.
 15. Anexpandable intervertebral fusion implant, comprising: a supportcomponent; at least one inferior component, including: a first proximateend connected to the support component; a first distal end; a first topsurface; a first bottom surface; and, a first aperture; at least onesuperior component, including: a second proximate end connected to thesupport component; a second distal end; a second top surface; a secondbottom surface; and, a second aperture; and, an expansion mechanismarranged between the first top surface and the second bottom surface andoperatively arranged to be expanded to displace the at least onesuperior component relative to the at least one inferior component. 16.The expandable intervertebral fusion implant as recited in claim 15,wherein the at least one superior component is hingedly connected to thesupport component.
 17. The expandable intervertebral fusion implant asrecited in claim 15, wherein the at least one superior component isconnected to the support component via one or more hinges.
 18. Theexpandable intervertebral implant as recited in claim 15, wherein thesupport component is adjustable in length.
 19. The expandableintervertebral implant as recited in claim 15, wherein the expansionmechanism is a balloon comprising at least one port, wherein the atleast one port is operatively arranged to allow fluid to be injectedinto and inflate the balloon.
 20. The expandable intervertebral implantas recited in claim 15, further comprising at least one limit cordoperatively arranged to limit the displacement of the at least onesuperior component relative to the at least one inferior component.